Lifestyle Factors Tied to Higher BP in Teens

Action Points

An Australian longitudinal study found that among 17-year-olds, boys had higher systolic blood pressure than girls especially if they drank alcohol; girls taking oral contraceptives had higher systolic readings than non-users.

Note that both sexes had higher systolic blood pressure at higher body mass index (BMI) and higher urinary sodium-to-potassium ratio, but the BMI effect was more apparent in boys.

Among 17-year-olds, oral contraceptive use by girls and alcohol consumption by boys were associated with increases in blood pressure, an Australian study showed.

In addition, although increasing body mass index (BMI) was related to higher systolic BP in both sexes, the slope was steeper among boys, Chi Le-Ha, of Royal Perth Hospital in Australia, and colleagues reported online in the European Journal of Preventive Cardiology.

"These substantial differences in systolic blood pressure in boys and girls, between those with a healthier versus a less favorable lifestyle pattern, are likely to significantly affect their risk of both ischemic heart disease and stroke in adulthood," the authors wrote.

"Our findings suggest that significant public health benefits may be achieved from implementation of a range of gender-appropriate lifestyle modifications within this age group of adolescents."

Le-Ha and colleagues examined the relationship between various health behaviors and blood pressure in late adolescence using data from the Western Australian Pregnancy (Raine) Study, a longitudinal investigation of mothers and their children recruited from the Perth area.

The current analysis included 1,248 of the offspring, who were assessed at age 17.

On average, systolic blood pressure was about 9 mm Hg higher among boys (118 versus 109, P<0.0001). The boys also had a higher average body mass index and larger waist size.

Overall, 8% of the teens were prehypertensive (90th to less than 95th percentile for systolic or diastolic blood pressure) and 7.8% were hypertensive (95th percentile for systolic or diastolic pressure). Using the adult cutoffs, however, resulted in values of 22.5% and 1.3%, respectively, with higher rates among boys.

After adjustment for potential confounders, male sex, alcohol consumption among boys, oral contraceptive use among girls, BMI, and the urinary sodium-to-potassium ratio were associated with systolic blood pressure.

Girls who used oral contraceptives had a blood pressure that was 3.27/1.74 mm Hg higher, on average, compared with nonusers, which is consistent with studies in adult women.

The relationship between blood pressure and the sodium-to-potassium ratio reinforces "the evidence in favor of a diet balanced for lower intake of salt-containing foods and higher intake of potassium-rich foods and vegetables," according to the researchers.

The association between higher BMI and elevated systolic blood pressure was magnified in boys compared with girls who were not taking oral contraceptives. For every 1-unit increase in BMI, systolic blood pressure rose by 0.65 mm Hg in boys and 0.38 mm Hg in girls who were not using oral contraceptives (P=0.028).

The sex difference likely has to do with the different effects of testosterone and estrogen on blood pressure regulation, the researchers said.

In an analysis combining several of these factors, boys who consumed alcohol and who were in the upper quartiles of both BMI and urinary sodium-potassium ratio had an average systolic blood pressure that was 5.7 mm Hg higher than nondrinkers in the lowest quartiles.

Similarly, girls who were taking oral contraceptives and who were in the highest quartiles of BMI and urinary sodium-to-potassium ratio had an average systolic blood pressure that was 5.5 mm Hg higher compared with girls who were not taking oral contraceptives and were in the lowest quartiles.

The authors acknowledged that the causality of all of these relationships remains uncertain because of the cross-sectional design of the study.

The study was supported by the National Health and Medical Research Council of Australia. Core management of the Raine Study is funded by the University of Western Australia (UWA), the Raine Medical Research Foundation, the Telethon Institute for Child Health Research, the UWA Faculty of Medicine, Dentistry, and Health Sciences, the Women and Infants Research Foundation, and Curtin University. Le-Ha is supported by an Endeavour Postgraduate Award from the Australian government.

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.